title: Patient care pathways under the model of integrating tuberculosis service with general hospitals in China.
abstract: OBJECTIVE
  To report care pathways of tuberculosis (TB) patients under the integrated model, where TB clinical service is provided by a general hospital instead of the TB dispensary, with the aim of providing policy recommendations for TB care reforms in China.
  
  
  METHODS
  Six counties implementing the integrated model were randomly selected, and 50 TB patients in each county participated in a questionnaire survey.
  
  
  RESULTS
  Of the 301 participants, 82 visited only the TB designated hospital. A patient visited a median of two health providers in total. The median external provider delay and internal provider delay were 1 and 0 day, respectively. The median out-of-pocket medical costs were US$379 in total; US$293 in the TB units and US$0 in other health units in the TB designated hospital. Logistic regression analyses suggested that patients who visited the primary care facilities first tended to have longer external delays (OR = 5.71) than patients who visited the other hospitals (OR = 10.16).
  
  
  CONCLUSIONS
  The integrated model is promising as it reported relatively fewer patient pathways and shorter delays than the dispensary model. However, the integrated model did not reduce patient out-of-pocket costs.
authors.affiliation: The Chinese University of Hong Kong, Hong Kong, China; Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of The Chinese University of Hong Kong, Shenzhen, Guangdong Province, China.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Wei
authors.forename: Jia
authors.initials: J
authors.lastname: Yin
authors.forename: Guanyang
authors.initials: G
authors.lastname: Zou
authors.forename: John
authors.initials: J
authors.lastname: Walley
authors.forename: Jiemign
authors.initials: J
authors.lastname: Zhong
authors.forename: Songhua
authors.initials: S
authors.lastname: Chen
authors.forename: Qiang
authors.initials: Q
authors.lastname: Sun
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D005260:Female; D019538:Health Care Surveys; D005102:Health Expenditures; D006757:Hospital Units; D006769:Hospitals, General; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D005791:Patient Care / Q000191:economics / Q000592:standards*; D010346:Patient Care Management / Q000592:standards*; D011320:Primary Health Care; D012017:Referral and Consultation / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D061665:Time-to-Treatment; D014376:Tuberculosis / Q000191:economics / Q000628:therapy*
keywords: China; integrated model; patient care pathways; tuberculosis